by Rahman R, Goyal V, Haque R, Jamil K, Faiz A, Samad R, Ellis S, Balasegaram M, den Boer M, Rijal S, Strub-Wourgaft N, Alves F, Alvar J, Sharma B. PLOS Neglected Tropical Diseases 2017, doi: 10.1371/journal.pntd.0005635.
Summary: AmBisome® therapy for VL has an excellent efficacy and safety profile and has been adopted as a first-line regimen in Bangladesh. Second-line treatment options are limited and should preferably be given in short course combinations in order to prevent the development of resistant strains. Combination regimens including AmBisome®, paromomycin, and miltefosine have proved to be safe and effective in the treatment of VL in India. This study reports on the safety and efficacy of these combinations (Amb+MF, Amb+PM, and PM+MF, vs Amb) in 601 patients in field conditions in Bangladesh. None of the combinations were inferior to AmBisome® in both the intention-to-treat and per-protocol populations. All the combinations demonstrated excellent overall efficacy, were well tolerated and safe, and could be deployed under field conditions in Bangladesh.